Information about conditions
is provided as a service to our patients for educational purposes only. "If
you understand your condition, you will be able to do the things necessary to
rehabilitate much faster." Please feel free to print the information so
that you can refer to it often. Sharing of information is quite risky, however.
Do not presume that information is meant for you if you have not seen the doctor
and received a specific diagnosis. Some conditions share similar symptoms but
require very different treatment. If you have friends or family who may have
similar symptoms, pleaseschedule
an appointmentto see the doctor.

Frozen Shoulder
(Adhesive Capsulitis)

Adhesive capsulitis is a perplexing shoulder disorder that is
both well recognized and controversial. It is characterized by prominent reduction
in the glenohumeral range of movement." Adhesive capsulitis has typically been
classified into two forms, primary and secondary. In the primary or idiopathic
form, no known precipitating event can be identified. The secondary form is
associated with or attributable to other illnesses or events. Although in many
cases the clinical disorder in the two types appears to be similar, there also
can be important differences.

For clarity, only the idiopathic form will be
discussed. The complexity of the condition stems from the complex nature
of the shoulder joint itself. Note the many layers and various ligaments
shown. The space shown around the joint is a very large circle and has a
great deal of surface. This contributes to the adhesions that form anywhere
along that surface.

Treatment and Rehabilitation

Physical therapy of the shoulder joint, supporting muscles and tissues is critical for several days at first when treatment begins and then 3 times a week for a few weeks with the onset of exercises Sometimes, Manipulation of the spine and surrounding tissue relieves the stress on the muscle attachments.

Proper exercises begun at the right time will reduce the strain on the muscles and improve function.

Elimination of repetitive friction motions will relieve the symptoms.

Recommendations:

For acute situations, utilize ice packs on the affected area until numbness
is reached.

Interferential current and Ultrasound therapy is effective in the healing
process.

At the appropriate time, stretches and strengthening exercises should be
implemented in the treatment regimen.

Treatment frequency is usually daily for 3-7 days and then three times a week
for 3-6 weeks. After that, realignment of the vertebra must be performed to
prevent eventual return of this condition. It can be accomplished in 30-60 days
of reduced frequency management. Often once a week treatment is sufficient at
that point to restore alignment. Thereafter, this condition can be reasonably
avoided with monthly correction of spinal alignment.

After the first few days of treatment, you will be given a sheet of stretching
exercises to do at home. This is to help reduce the treatment time and speed
healing. It is very important for you to do these daily as prescribed. If you
have any questions about them or difficulty or pain on performing them, please
tell the doctor right away.

Several days following the initiation of treatment, more aggressive exercise
routines will be proscribed for you. You will be taken to the rehabilitation
center and instructed on how to use the computer monitored exercise routines
specifically designed for this condition. The routines are monitored for completion
and graduated in difficulty after certain numbers of routines have been completed.
You will be expected to perform these routines after treatment during the initial
part of the restorative phase and throughout the rehabilitative phase of your
treatment. Our goal is to help you get well and stay well. We know from experience
that most mechanical conditions return gradually over a period of months and
become more advanced each time. The only way this can be prevented is with exercise.
We expect you to be successful.

We offer treatment of these conditions at various levels for all patients.
We expect that you will follow this treatment plan through to its logical conclusion
of restoration of complete function and rehabilitation. Our management system
is designed to help you remember all of your appointments and to be fully compliant
with all of our recommendations. At any time, should you decide to discontinue
the process, please just let us know so that we don't become a bother.

LIFE STYLE CHANGES: Long periods of stress should be avoided. Do not
sleep or lie on your stomach and avoid activities that hyper extend the neck.
Water intake should be increased substantially

SUPPLEMENTATION: Glucoseamine Sulphate and Trace Minerals: These supplements
have proven effective in long-term prevention of deterioration of joint tissues
and the disc. This may help reduce the mechanical breakdown associated with
three joint complex problems.

HOME REMEDIES AND RECOMMENDATIONS: Utilize ice packs on the neck back
for 10 minutes at a time and moist heat packs on the muscles of the upper back
at 20 minutes at a time, not simultaneously and not more often than once per
hour. This should continue until the arm pain or numbness disappears. Hot tubs
provide buoyancy and may be used after 5 days of onset for temporary relief.

Expectations

We understand that you have come here for help. We have spent many years learning
the best ways to solve the problems of mechanical back and neck pain. We expect
you to comply with our recommendations and follow our treatment schedule completely
regardless of the treatment plan you have. We expect you to set all of the recommended
appointments at times convenient for you and we expect you to keep all of them.
We expect you to respond favorably and know that your 100% compliance is the
determining factor. We also expect you to attend our next class on Absolute
Spinal Health. The staff can give you a schedule of the next class.

Other Information: At our class on Absolute Spinal Health, we discuss
mechanical conditions of the back, neck and spine and teach you ways to prevent
mechanical conditions from occurring. We also offer a wide variety of health
information at our web site. www.piclilnic.com All patients are welcome to use
our information to improve your life and maintenance your spinal health.

Maintenance: Regular spinal adjustments are important to reduce the
symptoms of bursitis. Patients who receive monthly spinal manipulation and therapy
report fewer complications with bursitis. It is important that you follow your
physician's advice about the frequency of treatment for your particular condition.